No abstract

A 63-year-old man presented with a 4-month history of a slowly growing soft mass at his right parieto-occipital region. Neuroradiological examinations revealed an osteolytic extradural tumour of the skull vault. The outer and inner tables of the skull were partially destroyed by the tumour, but the dura was not involved. The tumour and the invaded bone were totally removed and the skull defect was reconstructed using the outer table of the adjacent intact skull. Histopathological examination confirmed plasmocytoma. Laboratory investigations revealed no systemic myelomatosis. It is very important to differentiate solitary plasmocytoma from systemic myelomatosis since their treatment and prognosis are different. Although the prognosis of solitary plasmocytoma is good, regular follow-up examinations are required for any possibility to progress to systemic myelomatosis.

Mucoceles are cystic lesions of the paranasal sinuses which develop as a result of accumulation of mucous secretion due to obstruction of the ostium of the sinuses. Despite their benign behavior, they may enlarge progressively and project into adjacent structures by destructing the bony walls of the sinuses. Frontal mucoceles may get infected and extend towards orbital cavity and compress the orbit by eroding the bony walls of the orbital cavity. Endoscopic and external approaches are performed in the surgical treatment. We report a case of complicated fronto-orbital mucopyocele which eroded the orbital roof and extended into the orbital cavity and discuss the surgical treatment strategy under the light of the current literature.

Sciatica is characterized by pain and discomfort occurring frequently with impingement at the level of spinal nerve along the regions innervated by the sciatic nerve. Compression and irritation of the nerve often occurs with a spinal cause such as lumbar disc hernia or spinal stenosis. Compression of the nerve by an arteriovenous malformation is very rare among the causes leading to non-discogenic sciatic neuropathy. Herein, we reported our case with clinically and electrophysiologically typical sciatic neuropathy and treated by us surgically. To our knowledge, cases with arteriovenous malformation-caused sciatica were limited in the literature review. Electromyography should be performed to exclude the nerve compression due to rare causes such as vascular causes which may lead to sciatic neuropathy in patients with sciatic distribution symptoms and signs, after initial negative spine imaging.

Abs tractPulmonary embolism (PE) is a rare complication that may result in death after lumbar spinal fusion surgery. Although pulmonary embolism mortality rates decreased with early diagnosis and treatment, delays in the diagnosis of pulmonary embolism is commonly seen even with advanced diagnostic methods. Even though it is rare, the risk of pulmonary embolism as well as thrombophlebitis and deep vein thrombosis are encountered in patients undergoing spinal surgery. In this case presentation, we discussed the case of pulmonary embolism determined in a young patient developing unconsciousness and then cardiopulmonary arrest following mobilization at the postoperative 12 th hour after a lumbar spinal fusion surgery and determined to have severe right ventricular enlargement, leftward deviation of the interatrial septum, severe tricuspid failure at the bedside echocardiography and who was discharged after thrombolytic therapy. ( GirişPulmoner emboli (PE) lomber spinal füzyon ameliyatından sonra nadir görülen ve ölüme neden olabilen bir komplikasyondur. Özellikle postoperatif hastalarda masif PE semptom ve bulgularından nefes darlığı, göğüs ağrısı, hipotansiyon ve senkop PE'nin diğer klinik tablolarla karışmasına ve böylelikle tanı ve tedavisinde gecikmelere sebep olabilmektedir. Ekokardiyografi (EKO) ayırıcı tanının yapılmasında ve tedavinin yönlendirilmesinde önemli bir yardımcı tanı aracıdır (1). Sağ kalp boşluklarında yatak başı EKO ile mobil trombüsün görülmesi, tanıya çok değerli ve yeterli bir durum kazandırmaktadır. Sıklıkla hakkında veriler farklı olsa da, pulmoner embolisi olan vakaların %4'ünde, sağ kalp boşluklarından trombüsün pulmoner artere geçişli yakalanabilmektedir (2,3). Lomber spinal füzyon ameliyatı sonrası masif pulmoner emboli gelişen ve trombolitik tedaviye cevap veren olgunun gelişme sürecini sunmayı amaçladık. OlguBeyin cerrahisi polikliniğine; bel ve her iki bacakta ağrı şikayeti ile başvuran 44 yaşındaki bayan hastanın yapılan lomber manyetik rezonans (MRI) tetkikinde L4-L5 ve L5-S1 düzeyinde stenoz ve L4-L5, L5-S1 bilateral santral herniasyon izlenmesi üzerine operasyona karar verildi. Preoperatif yapılan anestezi değerlendirmesinde hipertansiyon tanısı